Development of the Prodromal Symptoms-Screening Scale (PS-SS): Preliminary Validity and Reliability

Every 40 seconds a person dies of cardiovascular disease.Individuals do not recognize the warning signs--prodromalsymptoms--of an imminent myocardial ischemic event. TheProdromal Symptoms-Screening Scale (PS-SS) is a nine-itemmeasure designed to evaluate PS in individuals with coronaryartery disease.

This article reports onfour studies (systematic review,focusgroup study, content validity testing and factor analysis) that contributed to the development and psychometric examination ofthe PS-SS.

PS experienced included: unusual fatigue, sleep disturbance, chest pain, anxiety, gastrointestinal symptoms andshortness of breath. The CVI derived was 0.85. The PS-SS presented a two-factor structure pertaining to Specific ProdromalSymptoms and Non-Specific Prodromal Symptoms. Internal consistency reliability was 0.61.

The PS-SS reflects current prodromal literature,clinical practice and ACS patients' experiences of PS. Furtheritem generation, clarity of symptom description and psychometricevaluation needs to occur prior to use in clinical practice.Keywords: prodromal symptoms, acute coronarysyndrome, psychometric testing, tool development